Sachin Patel, Guest
Thyroid Nation

Tips for taking your thyroid medication.

Thyroid medication is one of the top 5 medications prescribed in both the US and Canada.  Because it is so commonly prescribed, here are are some interesting facts which you may or may not know and which you may want to discuss with your healthcare provider.

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1. Take your thyroid medication on an empty stomach

Thyroid medication is best taken on an empty stomach because it ensures optimal absorption.  It should be taken 30 min to 60 min before breakfast and it should be taken 4 hours before or after drugs that interfere with it’s absorption (i.e.: iron, calcium, antacids, etc..)

2. Your thyroid medication may have gluten in it

Certain brands of thyroid medication are not certified gluten free.  They may contain excipients such as maltodextrin, dextri-maltose, pre-gelatinized starch or starch. These ingredients may be derived from wheat and therefore you have to be careful if you are on a gluten free diet or have Celiac disease.  The medications which most likely do not contain gluten are desiccated thyroid and compounded thyroid medications.  Check with your pharmacist if you are unsure.

3. The most commonly prescribed thyroid medication is biologically inactive 

Levothyroxine is a T4 medication.  Your cells are responsible for converting the storage form of the hormone, T4, into its active form, T3. This is a process dependent on optimal cortisol and nutrient availability such as iron, iodine, zinc, selenium, B vitamins, C, and D.  Therefore if you are deficient in any of the above nutrients, you may not be benefitting from your T4 based medication since it is not being converted to the active T3 form.

4. A compounded thyroid medication or a desiccated thyroid medication may be more suitable for some individuals. 

If you have been taking levothryoxine and you still have thyroid symptoms, you may not be converting the medication to the active form (T3).  Talk to your practitioner and functional medicine provider to find out why you are not converting your thyroid hormone (i,e: nutrient depletions).  You may also want to consider switching to a compounded thyroid medication (contains T4 and T3 that is specific for your needs) or switching to a desiccated thyroid medication.

5. Some individuals may benefit from taking their medication at bedtime

Two important studies — a 2007 study published in the journal Clinical Endocrinology, and a follow-up larger randomized trial reported in the December 2010 issue of the Archives of Internal Medicine — have found that taking the same dose of levothyroxine (i.e., Synthroid) at bedtime, as compared to first thing in the morning, may be better. These are some of the reasons:

  • Even when waiting at least 30-60 minutes to eat, your breakfast may be interfering with the intestinal absorption of levothyroxine.
  • “Bowel motility is slower at night,” which means that it takes longer for the levothyroxine tablet to transit through the intestinal system, resulting in longer exposure to the intestinal wall, and therefore, better uptake of the medication.
  • The conversion process of T4 to T3 may be more effective in the evening.

Please talk to your doctor before switching the timing of your medication and please also note that the studies were only done with levothyroxine.

As always, do not make any changes to your thyroid medication dosing/timing without the direction of your physician.


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About the Author

Dr. Sachin Patel

Dr. Sachin Patel, Functional Medicine and Lifestyle Medicine are his true passions. Dr. Patel uses Functional Medicine as a platform to transform the lives of his patients in the Cincinnati and Toronto area. He also serves as an author, speaker, health educator and corporate health consultant to organizations around the world. Dr. Patel is highly recognized by both large corporations and within his community as a “rare breed”.  He is the founder of TheLivingProofInstitute.com. Follow him on Facebook and Twitter.

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